Sweden's Strategy Backfired

41,191 Views | 251 Replies | Last: 4 yr ago by PJYoung
dermdoc
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Beat the Hell said:

"Nobody is rooting for the virus"

100% false


Disagree. At least not on here.

We just have folks with different opinions. Which is good. The problem is when we can not admit we could be wrong.
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Philip J Fry
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Another problem is that we don't have access to the multiverse where we can see what actually happened with different decisions. I said all along April 19th will be very bad for the country if we don't do something to bend the curve.

We did do something and the curve bent...and it will now be less bad.

We still have many more deaths to go through assuming we aren't all already infected. We can't stay shut down as a country forever and eventually we have to let the disease spread. So our only real hope is that we've given our doctors long enough to study this thing and come up with a treatment plan.
SRBS
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Derm doc, is it possible that the European (I presume, mutated) strain of the virus, which has hurt the east coast so bad is more deadly than the original Chinese strain on our west coast?
dermdoc
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SRBS said:

Derm doc, is it possible that the European (I presume, mutated) strain of the virus, which has hurt the east coast so bad is more deadly than the original Chinese strain on our west coast?


Anything is possible but doubt it. I think California and Washington had some immunity due to prior exposure.

And if you consider that an ad hom, please forgive me.
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TheAngelFlight
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What's the underlying theory for how two states could have "immunity before exposure" but others wouldn't?
Philip J Fry
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Visitors from China before the lockdown exposing everyone.
dermdoc
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TheAngelFlight said:

What's the underlying theory for how two states could have "immunity before exposure" but others wouldn't?


Frequent travel back and forth from China. I actually think my mother in law had the coronavirus at Christmas. Dry cough, hard to breath, etc. for about ten days. She has a good doc who keep her at his office for a day rather than sending her to a hospital where they might have put her on a vent. I think he saved her life:

And I had a lot of patients(as did my colleagues)with similar symptoms around Christmas.
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TheAngelFlight
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Philip J Fry said:

Visitors from China before the lockdown exposing everyone.


That just means things should have gotten worse (and then better) earlier in those states than a location which was exposed later.

That doesn't explain how they would seem to have less spread, cases, and deaths than another place, everything else equal.
dermdoc
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TheAngelFlight said:

Philip J Fry said:

Visitors from China before the lockdown exposing everyone.


That just means things should have gotten worse (and then better) earlier in those states than a location which was exposed later.

That doesn't explain how they would seem to have less spread, cases, and deaths than another place, everything else equal.


Unless this virus is not as bad as everyone thinks. I think it is worse than the flu. Especially on older people with co morbities. But basically it seems that a lot of people are basing how virulent this bug is only on symptomatic cases, which as a doc you know is extremely myopic. You just can not do that without knowing the denominator.

I worked with Fauci and epidemiologists from the NIH on HIV stuff. I was Dr. Pollack's derm source at Baylor College of Medicine. Smart people but man their predictions were way off as far as spread to the heterosexual population.

And read their stuff on the "bird" flu. Or SARS. They were way off.
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TheAngelFlight
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To expand, that's why comparative graphs often use timelines which are "days since X cases."

The calendar timing is different, but the curves end up looking similar if you use a more comparable timeline.

Think Italy and Spain, for example. It's turned out to be similar situations, Italy's breakout just started earlier.
TheAngelFlight
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I don't see how most of that's relevant to the conversation.

As to the size of the denominator, unless you have different quality of care or a different virus (strain, at least) than whatever the numerator and denominator are anywhere, the ratios (symptomatic to asymptomatic, death rate, etc.) should come out very similar.

Similarly, the virus should have a similar spread rate amongst populations absent behavioral differences. It should be just as contagious in California as New York as Timbuktu. It should be spread the same way in California as it is in New York and Timbuktu.

The difference is opportunity. Infected people have to get close to others. That happens a lot more in some places than others. And places implemented policies to stop that at different stages in the local spread.

I should note that yes, populations may be more susceptible. But New York isn't really different than say, California in health/age/etc.
dermdoc
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TheAngelFlight said:

To expand, that's why comparative graphs often use timelines which are "days since X cases."

The calendar timing is different, but the curves end up looking similar if you use a more comparable timeline.

Think Italy and Spain, for example. It's turned out to be similar situations, Italy's breakout just started earlier.


I personally think you can not extrapolate one countries experience with another. Too many variables. And that is why epidemiologists are often grossly wrong but never called on it.

So many diseases have ethnic genetic predispositions. And varying immune responses. Why should this be different?
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dermdoc
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TheAngelFlight said:

I don't see how most of that's relevant to the conversation.

As to the denominator, unless you have different quality of care or a different virus (strain, at least) than whatever the numerator and denominator are anywhere, the ratios (symptomatic to asymptomatic, death rate, etc.) should come out very similar.


Disagree. What diseases do that?

And without an accurate denominator of how many asymptomatic carriers there are(and from my study of viral diseases except for Ebola it is generally much larger than symptomatic patients)how can you determine anything? Basically everything is being determined by looking at symptomatic cases.
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The_Fox
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TheAngelFlight said:

I don't see how most of that's relevant to the conversation.

As to the denominator, unless you have different quality of care or a different virus (strain, at least) than whatever the numerator and denominator are anywhere, the ratios (symptomatic to asymptomatic, death rate, etc.) should come out very similar.


Doesn't that assume both locations have the same amount of older people, healthy people, fit people.

I imagine California has higher per capita fitness than NYC.
TheAngelFlight
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dermdoc said:

TheAngelFlight said:

To expand, that's why comparative graphs often use timelines which are "days since X cases."

The calendar timing is different, but the curves end up looking similar if you use a more comparable timeline.

Think Italy and Spain, for example. It's turned out to be similar situations, Italy's breakout just started earlier.


I personally think you can not extrapolate one countries experience with another. Too many variables. And that is why epidemiologists are often grossly wrong but never called on it.

So many diseases have ethnic genetic predispositions. And varying immune responses. Why should this be different?


I'm not making that claim. I'm saying dates of initial infection wouldn't lead, by itself, two places to different experiences. Other factors would.
dermdoc
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TheAngelFlight said:

dermdoc said:

TheAngelFlight said:

To expand, that's why comparative graphs often use timelines which are "days since X cases."

The calendar timing is different, but the curves end up looking similar if you use a more comparable timeline.

Think Italy and Spain, for example. It's turned out to be similar situations, Italy's breakout just started earlier.


I personally think you can not extrapolate one countries experience with another. Too many variables. And that is why epidemiologists are often grossly wrong but never called on it.

So many diseases have ethnic genetic predispositions. And varying immune responses. Why should this be different?


I'm not making that claim. I'm saying dates of initial infection wouldn't lead, by itself, two places to different experiences. Other factors would.


Oh I agree that close quarter, Mardi Gras, whatever cause a virus to spread more rapidly.

But I believe there were some close quarters in California also. And Washington. And if you take out the Washington nursing homes(obviously those folks would not have been exposed earlier)I think that the coronavirus has been in Washington and California longer than we think.

The problem is thinking in a box. And trying to apply numbers to what is seen in real life.

So on your med career, how many times have the epidemiologists been right? And how many times have they been called on it?
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BohunkAg
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The_Fox said:

TheAngelFlight said:

I don't see how most of that's relevant to the conversation.

As to the denominator, unless you have different quality of care or a different virus (strain, at least) than whatever the numerator and denominator are anywhere, the ratios (symptomatic to asymptomatic, death rate, etc.) should come out very similar.


Doesn't that assume both locations have the same amount of older people, healthy people, fit people.

I imagine California has higher per capita fitness than NYC.


There are just a TON of variables. Everyone is making this too simple. You could, for example, have a lot of folks in NYC with heretofore unknown lung damage from stuff in the air after 9/11
dermdoc
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BohunkAg said:

The_Fox said:

TheAngelFlight said:

I don't see how most of that's relevant to the conversation.

As to the denominator, unless you have different quality of care or a different virus (strain, at least) than whatever the numerator and denominator are anywhere, the ratios (symptomatic to asymptomatic, death rate, etc.) should come out very similar.


Doesn't that assume both locations have the same amount of older people, healthy people, fit people.

I imagine California has higher per capita fitness than NYC.


There are just a TON of variables. Everyone is making this too simple. You could, for example, have a lot of folks in NYC with heretofore unknown lung damage from stuff in the air after 9/11


And that is why epidemiologists are always wrong. Smart people that I like. But wrong.

And I am almost 65. And have never seen any patient that followed a "graph".
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TheAngelFlight
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I've never suggested diseases are simple ans Ive never spoken to an epidemiologist, and I hired a few in my day, who ever made such a claim.

My ONLY pointONLYhas been date of initial infections doesn't change a curve by itself. It only shifts the graph left or right. A 1000 and 1 other factors shape the curve.

And I've sought to make that point because you have the stated belief Washington and California had "prior immunity" as a reason for better outcomes than New York. If you're not not suggesting that that they earlier infections, than clarify and let's discuss what you meant.
dermdoc
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TheAngelFlight said:

I've never suggested diseases are simple ans Ive never spoken to an epidemiologist, and I hired a few in my day, who ever made such a claim.

My ONLY pointONLYhas been date of initial infections doesn't change a curve by itself. It only shifts the graph left or right. A 1000 and 1 other factors shape the curve.

And I've sought to make that point because you have the stated belief Washington and California had "prior immunity" as a reason for better outcomes than New York. If you're not not suggesting that that they earlier infections, than clarify and let's discuss what you meant.


With all due respect, you(very unprovoked) said that I all I did was ad homs and one liners and messed up a bunch of threads.

So considering that and what I believe I am dealing with, I will retire for the evening.

Happy Easter!

He is risen!
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TXAggie2011
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And there it is...
dermdoc
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TXAggie2011 said:

And there it is...


What? An ad hom? Or a one liner?

The obsession is kind of bothersome. But noted.
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California Ag 90
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Philip J Fry said:

California Ag 90 said:

TXAggie2011 said:

Californians spend half of their week in a car by themself on the 405. I think that's a big reason why they've not had the severe problems that the NYC metro are has seen.

Is that what you're asking?
and there you go - perfect illustration.

that statement is utterly absurd. the very definition of the sort of nonsense 'one liner' generalization you are accusing others of.




I live on LA County. What exactly is wrong with this statement?
uhhhh...not sure if serious...how about because 'california' isn't 'LA County'.


We're from North California, and South Alabam
and little towns all around this land...
TheAngelFlight
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dermdoc said:

TheAngelFlight said:

I've never suggested diseases are simple ans Ive never spoken to an epidemiologist, and I hired a few in my day, who ever made such a claim.

My ONLY pointONLYhas been date of initial infections doesn't change a curve by itself. It only shifts the graph left or right. A 1000 and 1 other factors shape the curve.

And I've sought to make that point because you have the stated belief Washington and California had "prior immunity" as a reason for better outcomes than New York. If you're not not suggesting that that they earlier infections, than clarify and let's discuss what you meant.


With all due respect, you(very unprovoked) said that I all I did was ad homs and one liners and messed up a bunch of threads.

So considering that and what I believe I am dealing with, I will retire for the evening.

So, you get mad that someone doesn't believe you actually want to discuss the topic. Then get mad and leave when that person attempts to discuss the topic with you.

What do you believe you are "dealing with?"
expresswrittenconsent
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BohunkAg said:

The_Fox said:

TheAngelFlight said:

I don't see how most of that's relevant to the conversation.

As to the denominator, unless you have different quality of care or a different virus (strain, at least) than whatever the numerator and denominator are anywhere, the ratios (symptomatic to asymptomatic, death rate, etc.) should come out very similar.


Doesn't that assume both locations have the same amount of older people, healthy people, fit people.

I imagine California has higher per capita fitness than NYC.


There are just a TON of variables. Everyone is making this too simple. You could, for example, have a lot of folks in NYC with heretofore unknown lung damage from stuff in the air after 9/11

Fair point but only a very small percentage of the current population of Manhattan lived there back in 2001.
TheAngelFlight
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And why were you resorting to dragging a profession through the mud as a response to my comments? My comments in this thread are my own.
dermdoc
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TheAngelFlight said:

dermdoc said:

TheAngelFlight said:

I've never suggested diseases are simple ans Ive never spoken to an epidemiologist, and I hired a few in my day, who ever made such a claim.

My ONLY pointONLYhas been date of initial infections doesn't change a curve by itself. It only shifts the graph left or right. A 1000 and 1 other factors shape the curve.

And I've sought to make that point because you have the stated belief Washington and California had "prior immunity" as a reason for better outcomes than New York. If you're not not suggesting that that they earlier infections, than clarify and let's discuss what you meant.


With all due respect, you(very unprovoked) said that I all I did was ad homs and one liners and messed up a bunch of threads.

So considering that and what I believe I am dealing with, I will retire for the evening.

So, you get mad that someone doesn't believe you actually want to discuss the topic. Then get mad and leave when that person attempts to discuss the topic with you.

What do you believe you are "dealing with?"


I am not mad. At all. But I seem to be very talented at making others mad.
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dermdoc
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TheAngelFlight said:

And why were you resorting to dragging a profession through the mud as a response to my comments? My comments in this thread are my own.

Huh?

And obviously they are your own. Including the ones about me me being a purveyor of ad homs and one liners. And a mucker up of threads.

So congrats?
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BeowulfShaeffer
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dermdoc said:



I am not mad. At all. But I seem to be very talented at making others mad.


Especially if they wear blue shirts, chest protectors, and face masks.
dermdoc
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BeowulfShaeffer said:

dermdoc said:



I am not mad. At all. But I seem to be very talented at making others mad.


Especially if they were blue shirts, chest protectors, and face masks.


We got umpires on here?
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BeowulfShaeffer
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On the COVID forum? Apparently so...
dermdoc
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BeowulfShaeffer said:

On the COVID forum? Apparently so...


Yep. And if you do not play by their rules, you are outta of here.

Oh wait. Is that a one liner?
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Tony Franklins Other Shoe
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dermdoc said:

BeowulfShaeffer said:

On the COVID forum? Apparently so...


Yep. And if you do not play by their rules, you are outta of here.

Oh wait. Is that a one liner?
Might be an ad hominy.
Philip J Fry
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California Ag 90 said:

Philip J Fry said:

California Ag 90 said:

TXAggie2011 said:

Californians spend half of their week in a car by themself on the 405. I think that's a big reason why they've not had the severe problems that the NYC metro are has seen.

Is that what you're asking?
and there you go - perfect illustration.

that statement is utterly absurd. the very definition of the sort of nonsense 'one liner' generalization you are accusing others of.




I live on LA County. What exactly is wrong with this statement?
uhhhh...not sure if serious...how about because 'california' isn't 'LA County'.





I honestly don't understand your point.
RGV AG
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Thank you, that is very kind of you. I really couldn't carry Derm's lunch bucket in terms of smarts, personality, and accomplishments. I just call em' like I see them.

At this stage of the deal all view points are good to hear and consider, including Angel's. Beetching at other posters, just doesn't add value and sends stuff off the rails.

It was/is interesting to read about the swedish situation, and many of the posts on this thread were informative.
 
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